RT Journal Article SR Electronic T1 Lung ultrasound-guided therapy reduces acute decompensation events in chronic heart failure JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 1934 OP 1939 DO 10.1136/heartjnl-2019-316429 VO 106 IS 24 A1 Claudia Marini A1 Gabriele Fragasso A1 Leonardo Italia A1 Hamayak Sisakian A1 Vincenzo Tufaro A1 Giacomo Ingallina A1 Stefano Stella A1 Francesco Ancona A1 Ferdinando Loiacono A1 Pasquale Innelli A1 Marco Fabio Costantino A1 Laura Sahakyan A1 Sirvard Gabrielyan A1 Mariam Avetisyan A1 Alberto Margonato A1 Eustachio Agricola YR 2020 UL http://heart.bmj.com/content/106/24/1934.abstract AB Objective Pulmonary congestion is the main cause of hospital admission in patients with heart failure (HF). Lung ultrasound (LUS) is a useful tool to identify subclinical pulmonary congestion. We evaluated the usefulness of LUS in addition to physical examination (PE) in the management of outpatients with HF.Methods In this randomised multicentre unblinded study, patients with chronic HF and optimised medical therapy were randomised in two groups: ‘PE+LUS’ group undergoing PE and LUS and ‘PE only’ group. Diuretic therapy was modified according to LUS findings and PE, respectively. The primary endpoint was the reduction in hospitalisation rate for acute decompensated heart failure (ADHF) at 90-day follow-up. Secondary endpoints were reduction in NT-proBNP, quality-of-life test (QLT) and cardiac mortality at 90-day follow-up.Results A total of 244 patients with chronic HF and optimised medical therapy were enrolled and randomised in ‘PE+LUS’ group undergoing PE and LUS, and in ‘PE only’ group. Thirty-seven primary outcome events occurred. The hospitalisation for ADHF at 90 day was significantly reduced in ‘PE+LUS’ group (9.4% vs 21.4% in ‘PE only’ group; relative risk=0.44; 95% CI 0.23 to 0.84; p=0.01), with a reduction of risk for hospitalisation for ADHF by 56% (p=0.01) and a number needed to treat of 8.4 patients (95% CI 4.8 to 34.3). At day 90, NT-proBNP and QLT score were significantly reduced in ‘PE+LUS’ group, whereas in ‘PE only’ group both were increased. There were no differences in mortality between the two groups.Conclusions LUS-guided management reduces hospitalisation for ADHF at mid-term follow-up in outpatients with chronic HF.